Coding... EWWW

Question 1

A patient is new if they haven’t been seen by your GROUP in the past ___ years (same specialty.

Answer 1

3

Question 2

What are the three elements of E&M? (evaluation and management)

Answer 2

History
Exam
Medical Decision Making

Question 3

How many ROS are recognized by CMS?

Answer 3

14 ROS

Question 4

In order for a patient completed checklist to count for ROS, what must you do?

Answer 4

Review it with the patient (document this)

Note the date and location of the checklist

Question 5

In order to bill a 4 or 5 for a new patient, how many ROS do you need?

Answer 5

10

Question 6

In order to bill a 4 or 5 for a new patient, how many HPI components do you need?

Answer 6

4

Question 7

In order to bill a 4 or a 5 how many components of the PE do you need?

Answer 7

8

Question 8

What differentiates a 4 from a 5?

Answer 8

Medical decision making and time.
High medical decision making and 60 min of time denote a 5
Moderate MDM and 45 min denote a 4

Question 9

How many organ systems are there?

Answer 9

12

Question 10

Are extremities an organ system?

Answer 10

No

Question 11

What system is is LE edema under?

Answer 11

CV

Question 12

JVP and carotid bruits are located under what?

Answer 12

CV

Question 13

EOMs are located under what PE category?

Answer 13

Neuro (not eyes)

Question 14

Gait and strength are located under which PE?

Answer 14

MSS

Question 15

To code a 1 how many HPI do you need? Exam? Time?

Answer 15

Only 1 HPI (no ROS or PFSH)
1 PE
straight-forward MDM
10 minutes

Question 16

To code a 2 what do you need?

Answer 16

1 HPI
1 ROS
2 PEs
straight-forward MDM
20 minutes

Question 17

To code a 3 how many ROS do you need?

Answer 17

2 ROS

Question 18

To code a 3 how many PFSH do you need?

Answer 18

1

Question 19

How many PE do you need for a 3?

Answer 19

5

Question 20

MDM is ____ for a 3.

Answer 20

low

Question 21

About how much time should a 3 take?

Answer 21

30 minutes

Question 22

For an established patient visit how many elements of history, exam, and MDM do you need?

Answer 22

Only 2 or the 3

Question 23

What should drive coding?

Answer 23

MDM and medical necessity

Question 24

For a return patient, outpatient visit, what is the lowest you can code?

Answer 24

2

Question 25

To code a 4 or 5 for a return patient, outpatient visit you need ___ things in HPI or ___ chronic items.

Answer 25

4 in HPI

or 3 chronic

Question 25

To code a 4 or 5 for a return patient, outpatient visit you need ___ things in HPI or ___ chronic items.

Answer 25

4 in HPI

or 3 chronic

Question 26

To code a 4 for a return patient you need ___ ROS and ___ PE and ___ PFSH

Answer 26

2 ROS
5 PE
1 PFSH

Question 26

To code a 4 for a return patient you need ___ ROS and ___ PE and ___ PFSH

Answer 26

2 ROS
5 PE
1 PFSH

Question 27

If you review a test yourself how many MDM points can you get?

Answer 27

2

Question 28

If you document date from old records or history from mothers how many point do you get?

Answer 28

2 points

Question 29

If greater than ____ % of patient encounter is spent w/ face to face counseling you can bill for counseling time.

Answer 29

50 %

Question 30

Do you need a CC or HPRI for preventative services?

Answer 30

No

Question 31

To code a 5 for a returning patient you need ___ ROS, ____ PFSH and ____ PE

Answer 31

10 ROS
3 PFSH
8 Exam